Guangpu Fan1, Xuan Wang2, Chen Chen3, Jing Liu4, Yu Chen5. 1. Department of Cardiac Surgery, Peking University People's Hospital, Beijing, China. gfan8692@hotmail.com. 2. Department of Cardiac Surgery, Peking University People's Hospital, Beijing, China. wangxuan0312@126.com. 3. Cardiac Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China. 347640364@qq.com. 4. Department of Cardiac Surgery, Peking University People's Hospital, Beijing, China. liujj5@163.com. 5. Department of Cardiac Surgery, Peking University People's Hospital, Beijing, China. chenyudoctor@163.com.
Abstract
BACKGROUND: Surgeon's preference is an important factor in clinical strategy for off-pump (OPCAB) or on-pump (ONCAB) coronary artery bypass graft (CABG) surgery. This study analyzed surgeons' understanding of and propensity for both techniques. METHODS: A survey was performed by self-reported questionnaire. Two sections were included: Q1 questionnaire investigated each surgeon's opinion on the indications of OPCAB and ONCAB; and Q2 questionnaire investigated each surgeon's choice of OPCAB or ONCAB in different clinical situations. RESULTS: The questionnaires were sent to 169 surgeons. In Q1, 71.2% of surgeons indicated that the degree of overlap between the indications of OPCAB and ONCAB is >70%; 55.1% believed that OPCAB had a wider scope of indications than ONCAB, and 35.3% believed that ONCAB had a wider scope of indications than OPCAB. In Q2, >70% of surgeons who responded chose OPCAB for patients with the following characteristics: high risk of stroke, renal dysfunction, pulmonary dysfunction, malignancy, clotting and coagulation disorders, or age ≥80 years. More than 57.5% of surgeons chose ONCAB for patients with poor target vessels or ventricular enlargement and dysfunction. For novice surgeons, 87.5% of surgeons chose ONCAB. CONCLUSION: Most surgeons surveyed agreed that OPCAB and ONCAB are suitable for most patients; however, surgeons' preference for ONCAB or OPCAB varied. Surgeons are more willing to choose ONCAB in the presence of complicated heart conditions and OPCAB in the presence of serious concomitant diseases.
BACKGROUND: Surgeon's preference is an important factor in clinical strategy for off-pump (OPCAB) or on-pump (ONCAB) coronary artery bypass graft (CABG) surgery. This study analyzed surgeons' understanding of and propensity for both techniques. METHODS: A survey was performed by self-reported questionnaire. Two sections were included: Q1 questionnaire investigated each surgeon's opinion on the indications of OPCAB and ONCAB; and Q2 questionnaire investigated each surgeon's choice of OPCAB or ONCAB in different clinical situations. RESULTS: The questionnaires were sent to 169 surgeons. In Q1, 71.2% of surgeons indicated that the degree of overlap between the indications of OPCAB and ONCAB is >70%; 55.1% believed that OPCAB had a wider scope of indications than ONCAB, and 35.3% believed that ONCAB had a wider scope of indications than OPCAB. In Q2, >70% of surgeons who responded chose OPCAB for patients with the following characteristics: high risk of stroke, renal dysfunction, pulmonary dysfunction, malignancy, clotting and coagulation disorders, or age ≥80 years. More than 57.5% of surgeons chose ONCAB for patients with poor target vessels or ventricular enlargement and dysfunction. For novice surgeons, 87.5% of surgeons chose ONCAB. CONCLUSION: Most surgeons surveyed agreed that OPCAB and ONCAB are suitable for most patients; however, surgeons' preference for ONCAB or OPCAB varied. Surgeons are more willing to choose ONCAB in the presence of complicated heart conditions and OPCAB in the presence of serious concomitant diseases.